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NPI Code Detail

MEDICARE: RHEA DIVINA LO ORTEZA DPT, CEEAA

MEDICARE: RHEA DIVINA LO ORTEZA DPT, CEEAA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist070017747IL

General Provider Information

NPI Number : 1386922466
Entity Type Code : Individual
Provider Name (Legal Business Name) : RHEA DIVINA LO ORTEZA DPT, CEEAA
Provider Business Mailing Address
First Line : 940 SHERWOOD GLN
Second Line :
City : PRINCETON
State : IL
Zip : 61356-2848
Country : US
Telephone Number : 917-602-5051
Fax Number :
Provider Business Practice Location Address
First Line : 2649 E 75TH ST
Second Line :
City : CHICAGO
State : IL
Zip : 60649-3835
Country : US
Telephone Number : 773-356-9300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/24/2011
Last Update Date : 01/15/2025

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